neonatal complications (PTB, RDS, TTN, MAS)

Question 1

classifications for high risk infants

Answer 1

-birth weight (LBW <2500 g)
-gestational age
-predominant pathophysiologic problems

Question 2

4 neonatal problems associated with prematurity

Answer 2

-developmental delays
-vision and hearing impairment
-persistent RDS
-cerebral palsy

Question 3

how long does resp distress usually last

Answer 3

72 hours after birth

Question 4

what age are corrected milestone ages continued until

Answer 4

2.5 yo

Question 5

cause of RDS

Answer 5

inadequate pulmonary surfactant

Question 6

risk factors RDS

Answer 6

-**prematurity
-maternal diabetes (IDM don’t produce surfactant until 36 wks)
-perinatal asphyxia
-male
-caucasian
-C/S

Question 7

S+S RDS

Answer 7

-immediate or within 6 hrs
-crackles (louder, persistent)
-poor air exchange
-pallor
-retractions
-apnea (>20 secs)

Question 8

how is Dx of RDS made

Answer 8

chest x-ray

Question 9

prevention RDS

Answer 9

-prevent/treat preterm birth
-accelerate surfactant production: antenatal steroids
-administer surfactant via ET tube at birth

Question 10

supportive care measures for baby with RDS

Answer 10

-thermoregulation
-resp support (vent)
-prevention of hypoTN and hypovolemia
-correct acidosis
-parenteral feedings (nursing takes too much energy)
-cluster care

Question 11

options for oxygen admin for RDS

Answer 11

-nasal cannnula
-CPAP
-mechanical vent (intubation - high frequency)
-ECMO

Question 12

cause of transient tachypnea of the neonate

Answer 12

delayed absorption of fetal lung fluid

Question 13

TTN

Answer 13

transient tachypnea of neonate

Question 14

risk factors TTN

Answer 14

-**C/S (esp not preceded by labor)
-smoking during pregnancy
-diabetic mom
-SGA, premature
-rapid vaginal birth

Question 15

S+S TTN

Answer 15

same RDS

Question 16

Dx TTN

Answer 16

chest xray: streaking

Question 17

Tx TTN

Answer 17

-O2
-nutrition: gavage, parenteral or IV fluids
-thermoregulation
-protect from infection
-maintenance of acid base balance

Question 18

does TTN self resolve?
does RDS?

Answer 18

TTN: yes
RDS: no, turns into BPD

Question 19

appearance of postterm baby

Answer 19

-decreased subq fat and muscle mass (“old person”)
-absent lanugo and vernix
-dry cracked peeling skin
-long nails
-meconium staining (skin, nails, cord)

Question 20

cause of meconium aspiration syndrome

Answer 20

-aspiration meconium
-negative pressure created
-hyperinflation of lungs, hypoxemia
-increased peripheral vascular resistance
-right to left shunting and return of fetal circulation
-chemical pneumonias, further decreases gas exchange

Question 21

risk factors meconium aspiration syndrome

Answer 21

-maternal diabetes/HTN
-difficult birth
-fetal distress
-intrauterine hypoxia (baby takes big gasps)
-advanced gestational age (>40 wk)
-IUGR

Question 22

S+S meconium aspiration syndrome

Answer 22

-meconium stained amniotic fluid
-meconium staining on baby
-S+S resp distress at birth
-hypothermia
-hypoglycemia, hypocalcemia
-coarse crackles on ausculatation
-visualization of meconium with ET tube

Question 23

Dx meconium aspiration syndrome

Answer 23

chest x-ray: trapped air, hyperinflated lungs, meconium

Question 24

Tx meconium aspiration syndrome

Answer 24

-prevention: check amniotic fluid, prevent distress
-chest physiotherapy
-tracheal suctioning at birth prn
-Abx and surfactant
-supplemental O2
-mechanical vent (ECMO)

Question 25

ECMO

Answer 25

extracorporeal membrane oxygenation